People with obesity face bias and discrimination every day. Unfortunately, this has numerous negative complications. Says the Obesity Action Coalition, “Research has demonstrated substantial impact on personal relationships, education attainment, professional achievement, and healthcare delivery.”
While the dietitian's office should be a “safe space” for weight loss patients, it doesn’t happen automatically. Rather, dietitians must be proactive when it comes to facilitating respectful communication with their weight loss patients. Start with these three tips.
Discrimination and bias are two different things. While the former refers to the unfair treatment of someone, bias refers to negative attitudes. While the latter may not involve any overt actions, they can still be damaging to people with obesity. Plus, biases are especially tricky because many people are unaware that they have them. Wondering about your own potential biases? Take Project Implicit’s online social attitudes test to learn where you stand.
We’ve all heard the expression, “Sticks and stones may break my bones, but words will never hurt me.” While this childhood rhyme may sound good, it’s simply not true. In fact, harsh words can and do hurt.
At the 3rd Annual International Weight Stigma Conference following a session on terminology and how to engage in conversations, researchers concluded: “At the end of the hour, the only thing that everybody agreed on what that there was no simple answer, other than to respect and honor the wishes of the person or people we were speaking to or about in any given situation.”
For starters, research from Johns Hopkins indicates that obese patients who feel judged by healthcare professionals are less likely to lose weight. Study leader Kimberly A. Gudzune, MD, MPH, said: “Negative encounters can prompt a weight loss attempt but our study shows they do not translate into success. Ideally, we need to talk about weight loss without making people feel like they are being judged. It’s a fine line to walk, but if we can do it with sensitivity, a lot of patients would benefit.
In addition to avoiding words like “fat,” “lazy,” “heaviness,” and “large size,” used words like “BMI,” “excess weight,” “weight problem,” and “unhealthy body weight,” instead. Person-first language is also preferable. For example, referring to someone as “a person with obesity” is preferable to referring to someone as “an obese person.” Not sure what terms a client prefers? There’s one simple way to find out: Ask.
In addition to facing discrimination and bias from their friends, coworkers and family members, people with obesity also encounter these issues from other people, as well: their healthcare teams.
'A lot of health care providers hold negative attitudes and in general have less respect for obese patients,” Gudzune says. This is problematic for several reasons, including the fact that lack of empathy directly impedes the patient-provider relationship.
Gudzune continues: “Forming that bond is really critical when thinking about whether the patient will listen to the advice you give them. When physicians have empathic conversations, their patients have better control of their blood pressure and cholesterol, they’re more satisfied with their care, and they’re more likely to follow through on care.”
This same principle applies to bariatric patient adherence to guidelines for diet and exercise. Which begs the question: How, exactly, can you improve your empathy as a dietitian? Gudzune recommends adopting empathetic language, such as “I know it’s frustrating,” and “I can see how you must be feeling” as a demonstration of concern and understanding.
There’s plenty of good news associated with improving communication with your obesity clients during consultations. Not only do respectful dietitians connect better with their clients, but they are also positioned to play particularly vital roles in supporting weight loss.
Gudzune concludes, “If we are their advocates in this process — and not their critics — we can really help patients to be healthier through weight loss.”